Barges In France, Division of Special Places Travel, LLC
"Barges in France (and the rest of Europe) ... for the experience of a lifetime!" ™
31 Torran Court · Edgewater, MD 21037   USA
Phone (toll-free): 1-877-64-BARGE (1-877-642-2743)
Outside of the U.S.: 1-443-321-3614
Fax: 1-240-465-3066 · E-mail: info@bargesinfrance.com
WEB: https://www.BargesInFrance.com
Founded 1997. Bonded. Member, ASTA, CLIA
Don Dillin, Sally Dillin, Chip Banister, Owners
PASSENGER BOOKING FORM and AGREEMENT
To confirm your booking, please complete this form (one form per cabin or per responsible party) with as much information as you have at this time, sign, date and return it to Special Places Travel, by fax, to 1-240-465-3066, or scan & email, or take a clear photo of each page and email to us at info@bargesinfrance.com
NAME OF BARGE:           CRUISE START AND END DATES:          
NO. OF PASSENGERS? ________
NO. OF CABINS? ________ 		Check  
One:   		 ___ CHARTER (charter terms apply)
 ___ INDIVIDUAL (individual terms apply)

Please complete the following for EACH passenger included in this reservation.

NO.

LAST NAME

FIRST NAME and MIDDLE INITIAL

TITLE (Mr Mrs Ms Dr)

DATE of BIRTH (day/month/year, e.g., 15 Oct 50)

PASSPORT EXPIRATION DATE (month/year)

NATIONALITY

Bed preference (where available): Queen (Q), or Two Twins (T)

Cost per Person, or Full Boat Charter

1

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

Total Cost For This Booking:  

 

Deposit:  

 

Balance Remaining:  

 
PAYMENT DETAILS: Payment should be made by check in US Dollars payable to "SPECIAL PLACES TRAVEL, LLC." 31 Torran Court; Edgewater, MD 21037; USA, by wire transfer, or by completing a credit card authorization form. See booking information for details.
EMERGENCY CONTACT:

NAME: ___________________________________________________ RELATIONSHIP: ____________

TELEPHONE NO.: _____________________________

SPECIAL DIETARY AND OTHER REQUIREMENTS: (Such as diabetic, vegetarian, etc., or allergies, so the chef can plan menus for everyone to enjoy. Please indicate any foods that you do NOT eat)




MOBILITY RESTRICTIONS OR MEDICAL CONDITIONS: (Specify the nature of any disability that may affect your cruise; a few barges have a dog in the captain's quarters - let us know if you have an allergy)




SPECIAL OCCASIONS DURING THE CRUISE: (Please provide date of birthdays, anniversaries, honeymoons, etc.)






SPECIAL INTERESTS DURING THE CRUISE: (Hot-air ballooning where available, golf, etc., may be available at extra cost.)




WHAT DATE ARE YOU LEAVING HOME FOR YOUR BARGE CRUISE? _________________
WHERE ARE YOU STAYING THE NIGHT BEFORE THE CRUISE? (Provide your hotel name, address, and phone number. If arriving in the region the day the cruise commences we will also need your train or other arrival details.)




TRAVEL PLAN / DESTINATION ON THE BARGE'S LAST DAY: (If departing by train we require your train schedule details, and also your post-cruise hotel and phone number.)





YOUR NAME (PLEASE PRINT): ______________________________________________________

ADDRESS: ____________________________________________________________________

CITY, STATE, COUNTRY, Postal Code: _______________________________________________

HOME PHONE: ________________________________     WORK PHONE: ________________________________

CELL PHONE: _______________________     CELL PHONE with you in Europe: _______________________

FAX: ________________________     EMAIL: ______________________________________

Please let us know how the barge crew should address you (e.g., "Bob, Mary, Dr. Smith," etc.):

AGREEMENT and ACCEPTANCE of TERMS & CONDITIONS: On behalf of all persons named above, I understand and accept the barge owner's/operator's terms and conditions for this cruise, for which I acknowledge receipt. I understand that unless the terms and conditions state otherwise, all deposits and payments are non-refundable, and any changes may be subject to a fee, as specified in the terms.

I acknowledge that trip cancellation/interruption insurance is strongly recommended by Special Places Travel, and I will make my own arrangements to purchase such insurance unless I specifically decline, below.
Please check one:         __ YES, I will make my own arrangements to purchase trip cancellation insurance.
__ NO, I will not be purchasing trip cancellation insurance.

I agree that Special Places Travel is not liable or responsible for personal injury or death, property damage or loss occasioned by theft, vandalism, fire, water, weather conditions, explosion, or any other cause, or any loss arising out of the acts or omissions, whether negligent or intended, of any third party, any condition which is beyond the control of Special Places Travel, including Acts of God, flooding of rivers or canals, strikes, lockouts, work stoppages, riots, governmental acts, terrorism, criminal activity, passenger illness, and any additional expenses incurred by the passenger as a result of any delay or failure of and/or by the owners and contractors of any and all services connected with the specific booking; and any loss sustained by the Passenger as a result of any cancellation, delay, advancement or postponement of any tour. Any booking or reservation made through Special Places Travel is a contract between the passenger and the owner of or contractor representing hotel barges, barge operators, tour operators, airlines, hotels and places of abode, and I acknowledge that Special Places Travel assumes no responsibility or liability for any acts or omissions connected therewith.


SIGNATURE: ____________________________________________     DATE _________________

Rev: 28 Aug 2019